Diabetes Insipidus DDx

  • Nature: Excessive loss of hypotonic urine
  • Treatment: Fluid resuscitation greater than urine output


Central (Failed ADH secretion)

  • Idiopathic (30%)
  • CNS (60%)
    • Tumour 25%
    • Pituitary surgery, Sheehan’s, panhypopituitarism (20%)
    • Head trauma (15%)
    • CNS infection
    • CVA, Aneurysm
    • Sickle cell anaemia
    • Respiratory (10%) (usually granulomatous disease)

Nephrogenic (No response to ADH) (Failed concentrating ability)

  • HYPOkalaemia, hypercalcaemia
  • Renal disorders (myeloma, amyloidosis, ATN, TIN)
  • Drugs as below


  • alcohol
  • phenytoin
  • amphotericin
  • sulphonylureas
  • colchicine
  • gentamicin

References and Links

CCC 700 6

Critical Care


Associate Professor Curtin Medical School, Curtin University. Emergency physician MA (Oxon) MBChB (Edin) FACEM FFSEM Sir Charles Gairdner Hospital.  Passion for rugby; medical history; medical education; and asynchronous learning #FOAMed evangelist. Co-founder and CTO of Life in the Fast lane | Eponyms | Books | Twitter |

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